Provider Demographics
NPI:1609015072
Name:STEVE LONGACRE M.D. PA
Entity Type:Organization
Organization Name:STEVE LONGACRE M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGACRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-683-0300
Mailing Address - Street 1:1905 DOCTORS HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:TX
Mailing Address - Zip Code:76426-2260
Mailing Address - Country:US
Mailing Address - Phone:940-683-0300
Mailing Address - Fax:940-683-0450
Practice Address - Street 1:1905 DOCTORS HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:TX
Practice Address - Zip Code:76426-2260
Practice Address - Country:US
Practice Address - Phone:940-683-0300
Practice Address - Fax:940-683-0450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty